Friday, July 31, 2009

The Body Politic

Health care is a game-changer. The permanent game-changer. The pendulum will swing, and one day, despite their best efforts, the Republicans will return to power, and, in the right circumstances, the bailouts and cap-&-trade and Government Motors and much of the rest can be reversed. But the government annexation of health care will prove impossible to roll back. It alters the relationship between the citizen and the state and, once that transformation is effected, you can click your ruby slippers all you want but you’ll never get back to Kansas.

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Government-directed health care is a profound assault on the concept of citizenship. It deforms national politics very quickly, and ensures that henceforth elections are always fought on the left’s terms. I find it hard to believe President Obama and his chums haven’t looked at Canada and Europe and concluded that health care is the fastest way to a permanent left-of-center political culture. He doesn’t say that, of course. He says his objective is to “control costs”. Which is the one thing that won’t happen. Even now, health care costs rise far faster under Medicare than in the private sector.

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When health care is the government’s responsibility, it becomes its principal responsibility. Because the minute you make government the provider of health care, you ensure that, come election time, the electorate identifies “health” as its number one concern. Thus, in a democracy, the very fact of socialized medicine seduces the citizenry away from citizenship. Buying health care is no more onerous than buying a car or buying a house – which, pre-Barney Frank, most Americans seemed able to manage. Indeed, most of the complications are caused by existing government interventions. If you were attempting to devise a “system” from scratch, you might opt for insurance for catastrophic scenarios and, for PAP smears and colonoscopies and whatnot, something similar to the tax breaks for a Simplified Employee Pension: C’mon, how difficult can it be? Back in the day, your grampa managed to go to the doctor without routing the admin through Washington. Matter of fact, the doctor came to grampa. That’s how crazy it was.

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the acceptance of the principle that individual health is so complex its management can only be outsourced to the state is a concession no conservative should make. More than any other factor, it dramatically advances the statist logic for remorseless encroachments on self-determination. It’s incompatible with a republic of self-governing citizens. The state cannot guarantee against every adversity and, if it attempts to, it can only do so at an enormous cost to liberty. A society in which you’re free to choose your cable package, your iTunes downloads and who ululates the best on “American Idol” but in which the government takes care of peripheral stuff like your body is a society no longer truly free.